When bipolar disorder and substance use happen together, the effects can feed off each other. This can lead to a worsened mood, strained relationships, and more difficulty in getting through each day. Research shows that nearly 24% of people with bipolar II disorder use alcohol to cope, and about 19% turn to drugs. When addiction and bipolar disorder occur together, each one makes the other harder to manage.
Integrated treatment, also known as dual diagnosis treatment, works to support healing from addiction and managing mental health conditions at the same time. Therapies and medication treatments work in sync, instead of pulling the person in different directions. Treating both conditions together leads to better outcomes than addressing them separately.
At Lennox CMHC in Van Nuys, California, we offer compassionate, evidence-based dual diagnosis treatment. We’re dedicated to helping individuals break free and build lasting recovery.
What is Bipolar Disorder?
Bipolar disorder isn’t just having good days and bad days. It’s experiencing extreme highs and crushing lows that can completely shift how a person thinks, acts, and feels. These shifts include manic or hypomanic episodes (periods of unusually high energy) and depressive episodes (periods of deep sadness).
Common symptoms of bipolar disorder include:
- Manic episodes: Elevated or irritable mood, increased energy, reduced need for sleep, impulsive or risky behavior
- Depressive episodes: Persistent sadness or hopelessness, loss of interest in activities, fatigue, difficulty concentrating
During depressive episodes, some individuals turn to alcohol or drugs to cope, creating patterns that can worsen symptoms of both conditions over time.
Types of Bipolar Disorder
There are multiple types of bipolar disorder, all of which can drastically affect a person’s life. It’s very important to identify the correct type of bipolar disorder (with the help of mental health professionals) so that medication and lifestyle changes can be properly attuned.
Type | Key Characteristics |
|---|---|
Bipolar I | Full manic episodes lasting at least 7 days (lasting most of the day), alternating with depressive episodes lasting at least two weeks. |
Bipolar II | Hypomanic episodes (less intense than mania) with major depressive episodes that may persist. |
Cyclothymic Disorder | Milder but chronic mood swings that are not as intense or long enough to meet the criteria for mania or depression. |
Any type of bipolar disorder can happen alongside addiction, which is why treating both together is so important.
How are Bipolar Disorder and Addiction Connected?
Bipolar disorder and substance use disorders occur together at rates much higher than in the general population. Research shows that up to 56% of people with severe mental illness also have a substance use disorder. Substance use disorders represent the most significant predictor of medication non-adherence in people with bipolar disorder.
Many people turn to using drugs or drinking alcohol during mood swings, in an attempt to self-medicate and feel better. During depressive episodes, individuals may turn to substances to lift their mood. During manic episodes, they may use substances to calm racing thoughts. Substances might feel like relief at first. But they end up making your moods even more unpredictable.
The bidirectional relationship can be described as thus (in most cases):
- Bipolar symptoms leading to substance use: Attempting to manage depression, trying to control manic energy, coping with unpredictable mood swings.
- Substance use worsening bipolar disorder: Triggering new mood episodes, interfering with prescribed medications, or disrupting healthy sleep patterns.
Drug use doesn’t cause bipolar disorder, but it can trigger episodes if someone is already at risk. It can also hide early warning signs, making it harder to get the correct diagnosis.
Why Does Dual Diagnosis Treatment Help?
Integrated treatment sees bipolar disorder and addiction as interconnected struggles, not unrelated issues. When your providers treat both conditions at once, you get consistent support from a team that understands how mental health and addiction overlap.
Treating just one condition leaves you at risk for relapse. Substance use can trigger mood episodes, while untreated mood symptoms often lead to self-medication with drugs or alcohol.
Benefits of integrated bipolar and addiction treatment include:
- Coordinated care: All providers work together with consistent goals, preventing conflicting treatment approaches.
- Addressing root causes: Treatment targets underlying emotional and psychological factors driving both conditions.
- Lower relapse rates: Individuals develop coping skills that promote both mood stability and awareness of substance use triggers.
- Improved medication adherence: Coordinated care helps individuals stay on track with mood stabilizers while reducing cravings.
What Types of Therapy Help with Bipolar Disorder and Addiction?
The most effective bipolar and addiction treatment starts with therapies proven to work. These therapies tackle mood episodes and substance use patterns at the same time.
Cognitive Behavioral Therapy (CBT) helps individuals recognize and change negative thought patterns that contribute to both mood episodes and substance use. CBT gives you real skills to spot your triggers and stop relapse before it starts. With relapse prevention, CBT reduces hospitalizations. It also improves abstinence rates in people with co-occurring disorders.
Dialectical Behavior Therapy (DBT) builds four core skills: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. These skills help manage intense emotions and impulsive behaviors common in bipolar and addiction treatment. DBT helps you accept where you are right now while building practical ways to handle stress and cravings without turning to substances.
Eye Movement Desensitization and Reprocessing (EMDR) processes trauma that often underlies both bipolar disorder and addiction. EMDR uses bilateral stimulation, a technique that helps the brain reprocess trauma and lessen its emotional grip. By addressing trauma, EMDR supports long-term recovery from both conditions.
Group therapy with an integrated format treats bipolar and substance abuse as a single disorder rather than two separate conditions. Participants are more than twice as likely to be both abstinent from substance use and mood episode-free compared to non-integrated approaches.
Treatment Levels for Dual Diagnosis Treatment
From intensive daily programs to flexible outpatient care that fits around life obligations, there is a full range of treatment options available for supporting recovery.
Partial Hospitalization Programs (PHP) offer intensive daily treatment while allowing individuals to live at home. Most PHPs include several hours of therapy each day, five days a week, including individual counseling, group sessions, and medication check-ins. PHPs can serve as a step-down from inpatient care or as an intensive starting point for those who don't require 24-hour supervision.
Intensive Outpatient Programs (IOPs) provide structured treatment several times per week. IOPs offer flexibility for work and family responsibilities while delivering comprehensive bipolar and addiction treatment. Individuals typically attend sessions three to five days per week for several hours each day. An IOP can work well if you're stepping down from a PHP or need more support than therapy alone can offer.
Standard outpatient programs involve ongoing individual and group therapy sessions. Ongoing care helps people to stay stable and avoid relapse over the long haul. Individuals typically attend weekly or bi-weekly sessions while managing daily responsibilities.
What Role Can a Person’s Family Play in Recovery?
When family gets involved, recovery outcomes improve for people dealing with both bipolar disorder and addiction. Treatment programs that include family therapy sessions are linked to lower relapse rates and improved long-term functioning.
Benefits of family involvement can include:
- Education: Learning about both conditions helps family members to recognize symptoms, understand triggers, and respond appropriately.
- Support system: Family participation creates stable home environments that can reinforce treatment goals.
- Communication skills: Therapy teaches families how to discuss concerns clearly and set healthy boundaries.
Aftercare services that include family involvement can provide support beyond initial treatment.
Frequently Asked Questions about Bipolar and Addiction Treatment
Drug use doesn't cause bipolar disorder, but it can trigger episodes if someone is already at risk and hide the early signs. This can make it harder to get an accurate diagnosis.
The length of treatment depends on the situation, but many people benefit from several months of intensive therapy followed by ongoing care. Treatment plans are customized to suit the needs of the individual.
Most insurance plans cover dual diagnosis treatment under mental health and addiction benefits, especially those following mental health parity laws. But coverage details may vary by provider.
Relapse is a common part of recovery, not a personal failure. Integrated programs offer immediate support, help the person identify what triggered it, and can adjust their treatment plan to help them get back on track.
Get Mental Health and Addiction Support at Lennox CMHC
With the right integrated treatment, recovery isn’t just possible but within reach. Lennox CMHC’s evidence-based approach and compassionate care team are here to support you every step of the way.
For individuals or loved ones facing bipolar and addiction challenges, we encourage you to contact us to verify insurance or learn more about our treatment programs. Our team is committed to helping you achieve lasting recovery and a brighter future.